Comparison of subjective, objective and patient-reported cosmetic outcomes between accelerated partial breast irradiation and whole breast radiotherapy: a prospective propensity score-matched pair analysis

Breast Cancer ◽  
2019 ◽  
Vol 27 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Tabassum Wadasadawala ◽  
Shwetabh Sinha ◽  
Vani Parmar ◽  
Shalini Verma ◽  
Mithila Gaikar ◽  
...  
Keyword(s):  
Accelerated Partial Breast Irradiation ◽  
Matched Pair ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
Breast Radiotherapy ◽  
Matched Pair Analysis ◽  
Whole Breast Radiotherapy ◽  
Patient Reported ◽  
Cosmetic Outcomes ◽  
Pair Analysis

Clinical efficacy of 2-day versus 5-day accelerated partial breast irradiation delivered via balloon-based brachytherapy: Results of a matched pair analysis.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 148-148
Author(s):  
Peter Y. Chen ◽  
Chirag Shah ◽  
John Ben Wilkinson ◽  
Michelle Wallace ◽  
Hong Ye ◽  
...  
Keyword(s):  
Early Stage ◽  
Clinical Stage ◽  
Distant Metastases ◽  
Accelerated Partial Breast Irradiation ◽  
Matched Pair ◽  
Partial Breast Irradiation ◽  
Patient Scheduling ◽  
Breast Irradiation ◽  
Matched Pair Analysis ◽  
Pair Analysis

148 Background: This analysis compares the efficacy of a 2-day vs. 5-day accelerated partial breast irradiation (APBI) schedule in treatment of early-stage breast cancer. Methods: Patients were treated between 6/2000 and 1/2011 with balloon-based brachytherapy using a 2-day (700 cGy x 4 BID) or a 5-day (340 cGy x 10 BID) fractionation. The CTV was a 1cm expansion from the balloon surface with a single-lumen device used in all cases. To compare efficacy between the two treatment groups, a matched-pair analysis was performed using a 1:2 ratio which paired 38 two-day with 76 five-day patients. Match criteria included minimal follow-up (FU) > 1.0 yr, clinical stage, age (+/- 3 yrs), and ER status. Clinical outcomes analyzed include local-regional recurrence [LR, RR] distant metastases (DM), disease-free, cause-specific and overall survival [DFS, CSS, and OS]. Results: No significant differences were noted for age (p=0.838), clinical stage (p=1.000), ER (p=1.000), tumor size (p=0.236), margin status (p=0.556), nodal stage (p=0.381), PR (p=0.749), use of chemotherapy (p=0.927) or endocrine therapy (p=0.129). Per the ASTRO Consensus Guidelines, no differences were noted in the clinical groups between the 2-and 5-day treatments with the majority categorized as suitable or cautionary (2-day: 92% vs. 5-day: 87% p=0.436). With a mean FU of 4.7 yrs (4.9 yrs for 2-day vs. 4.5 yrs for 5-day, p=0.279), no differences were seen in the 5-year actuarial rates of LR (0.0% vs. 2.6%, p=0.359), DFS (94.4% vs. 96.1%, p=0.618), CSS (100% vs. 94.9 %, p=0.207), or OS (97.3% vs. 92.5%, p=0.811) between the 2-and 5-day groups, respectively. There was no RR in either group. DM rates were similar for both (5.6% vs. 1.3 %, p=0.456). Conclusions: With near 5-year FU for the 2-day schedule, APBI with the 2-day regimen yielded outcomes equivalent to the 5-day schema. Reduced on-treatment days by such hypofractionation offers flexibility in clinical and patient scheduling. Further FU and more patients will be needed to substantiate equivalence of hypofractionated APBI. An HIC-approved protocol randomizing patients between the 2 vs. 5-day treatments is currently open for accrual at our institution.

Ten-year outcomes of accelerated partial breast irradiation compared with whole breast irradiation: A matched-pair analysis.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 55-55
Author(s):  
Jessica Wobb ◽  
Michelle Wallace ◽  
Chirag Shah ◽  
Hong Ye ◽  
Maha Saada Jawad ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Accelerated Partial Breast Irradiation ◽  
Matched Pair ◽  
Partial Breast Irradiation ◽  
Whole Breast Irradiation ◽  
Breast Irradiation ◽  
Matched Pair Analysis ◽  
Pair Analysis ◽  
Er Status

55 Background: Breast conserving therapy (BCT) represents a standard of care in the management of early stage breast cancer; while adjuvant radiation therapy was traditionally delivered using whole breast irradiation (WBI), accelerated partial breast irradiation (APBI) offers an alternative to WBI that shortens the duration of treatment and may improve toxicity profiles and quality of life. The purpose of this analysis is to compare clinical outcomes of patients treated with WBI versus APBI. Methods: A total of 3,009 patients were treated with BCT at single institution between 1980 and 2012 with 2,528 patients receiving WBI and 481 patients receiving APBI (interstitial or balloon-based). A matched-pair analysis was performed with patients matched according to age (+/- 3 years), T stage (Tis vs T1 vs T2), and estrogen receptor (ER) status (+/-). All patients had a minimum of 12 months of follow up. A total of 247 matches were made with clinical outcomes compared using the Kaplan-Meier method. Results: Mean follow-up was 8.1 years for WBI vs. 7.8 years for APBI (p<0.001), a difference of less than 4 months. There were no differences with respect to age (p=0.88), tumor stage (p=1.0), or ER status (p=1.0). Long-term cosmesis was good to excellent in 94% vs. 95% of patients (p=0.78). WBI patients demonstrated a trend for slightly larger tumors (13.0 vs. 11.4 mm, p=0.06). At 10 years, no difference in ipsilateral breast tumor recurrence (4% vs. 4%, p=0.11), regional recurrence (1% vs. 1%, p=0.20), distant metastases (3% vs. 6%, p=0.47), disease free survival (93% vs. 91%, p=0.10), or contralateral breast failure (9% v. 3%, p=0.06) was noted when comparing WBI and APBI. In addition, 10 year cause-specific survival (94% v. 93%, p=0.72) and overall survival (83% vs. 75%, p=0.34) were similar. Conclusions: At 10 years, no differences in locoregional recurrence, distant metastasis or survival were found between patients undergoing whole breast irradiation or accelerated partial breast irradiation using interstitial catheter or balloon-based brachytherapy. These data represent one of the only APBI series with prolonged follow-up and show similar outcomes in a matched group of patients undergoing WBI or APBI.

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